Water and Human Health

“Don’t ever take a fence down until you know why it was put up.” Robert Frost.

This planet is mainly a mass of water and only a small portion of it is land. Despite all that only a minute share of water in the planet (2.5%) is potable. Most of the latter is locked up as ice while only one per cent is available in lakes, rivers and underground water tables for human consumption. Human body is 65-70% water. Therefore, human health and life on this planet depend on water to a very great extent. If one understands this one could easily comprehend how important it is to keep the water balance adequate to remain healthy all through one’s life.

Water makes up more than two thirds of the weight of the human body. Human brain is made up of 95% water; blood is 62% and lungs 90%. Even as little as 2% drop in body water could trigger dehydration. This is not easily made out as thirst is a rather late symptom of dehydration. Early signs include day time fatigue, fuzzy short-term memory, trouble with mathematics, difficulty in focusing on small print and the computer screen, and muscle pains.

Water is very essential for many of the body functions just as oil and petrol are needed for a car to run. Every cell function needs water. Water serves as a lubricant, it forms the base for saliva, makes up the fluids that bathe the joint capsule, controls the body temperature, regulates metabolism and helps maintain the normal healthy bowel motion. In addition, adequate water intake is essential to keep diseases at bay. Even common cold, sore throat, and ‘flu like illnesses could be prevented to a great extent with adequate hydration to keep the mucus membranes healthy to resist the onslaught of viruses. The minor illness syndromes, mentioned above, are the ones that cause the largest sick-absenteeism in the world every day causing billions of dollars loss to the industry.

Water borne illnesses:

Long before modern hi-tech medicine became available industrialized world had been able to contain the water related diseases through good water management. Still some epidemics do occur when the vigil is less. The developing countries have not been that successful. Diseases due to bad hygiene lead the causes of death and blight the lives of the poor. The poor pay for their poverty with their lives.

In addition, the blood sucking water salesmen in these countries take away a large chunk of their paltry income by selling them not good quality water through tankers etc. It is estimated by the WHO that around 3.4 million people, mostly children, die annually of water related diseases. All of these are preventable deaths. Even a simple disease like trachoma, the greatest cause of early blindness, which affects about 146 million people in the world today is a rarity in places where basic water supply, sanitation, and good hygiene prevail.

Study after study has shown that where a community improves its water supply, hygiene and/or sanitation the health improves. For example, diarrhoea can be reduced by 26% when basic water, hygiene and sanitation are supplied. Yet statistics tell a terrible story. Forty percent of the world’s six billion people have no acceptable means of sanitation, and more than 1 billion people draw their water from unsafe sources. Almost 70% of the 1.3 billion people living in extreme poverty are women. Women – especially poor women – are often trapped in a cycle of ill-health exacerbated by childbearing and hard physical labour.

“Safe water supply and adequate sanitation to protect their health are among the basic human rights. Ensuring their availability would contribute immeasurably to health and productivity for development. “Business as usual” is no longer an option. We don’t have enough time to just wait for large infrastructure investments to provide these basic services to all who need them. Several simple interventions are available, such as improving the quality of water in the home as well as improving hygiene education at the household level. Poor people can take charge of their own destinies and improve their lives by applying some of these measures. But they need to know what works and how such interventions can be exploited. People everywhere can use the World Water day on March 22nd to raise awareness of the high level of disease and misery that results from bad and inadequate water sources. People can learn that they need not be victims, but can take matters into their own hands to create good, clean water for better health,” writes Gro. Harlem Brundtland, Director-General of WHO in her letter.

The World Health Organization says diarrhoeal diseases remain a leading cause of illness and death in the developing world. Every year, about 2.2 million people die from diarrhoea; 90% of these deaths are among children, mostly in developing countries. A significant number of deaths are due to a single type of bacteria, Shigella, which causes dysentery or bloody diarrhoea. It is readily controlled by improving hygiene, water supply and sanitation. Although no vaccine exists and antibiotics may be inaccessible to many people, an effective intervention is available. The simple act of washing hands with soap and water reduces Shigella and other types of diarrhoea by up to 35%.

Water Management To Reduce diseases:

The transmission of disease is also rife among vulnerable communities because they live in environments receptive to the breeding of insect vectors that carry parasites such as malaria, filaria and trypanosomes. Most of these need water for part of their life-cycle. 300 million people suffer from malaria and in sub-Saharan Africa alone malaria kills an estimated 1 million people per year, the large majority are children under five. Other malaria hotspots are South and South-East Asia, and parts of South America.

Rice fields may thus be flooded for weeks and become important breeding places for Culex mosquitoes which can transmit Japanese encephalitis. Outbreaks of the disease kill at least 20% of people suffering clinical symptoms – mainly children. Twenty per cent of survivors are left with permanent damage to their central nervous system. Trachoma, another common malady, can be prevented by improving sanitation, reducing the breeding sites of flies and teaching children to wash their faces with clean water. Trachoma caused by microscopic Chlamydia trachomasis remains the leading cause of preventable blindness – with an estimated 6 million people suffering loss of sight and 146 million acute cases worldwide.

Gross inequalities in the reliability and quality of water supply create a market for water vendors and encourage them to use unsafe local well and pipes in urban slums. Anaemia, arsenicosis, ascariasis, campylobacterisois, cholera, typhoid, cynobacterial poisoning, dengue, diarrhea, dysentery, flurosis, guinea-worm infestation, Japanese encephalitis, infectious hepatitis, impetigo, lead poisoning, malaria, malnutrition, tinea cruris infection, scabies, and trachoma could all be due to water scarcity and bad water.

What to do about this?
* In far flung villages, as a temporary measure, sun light could be used to sterilize water. Transparent plastic bottles could be used to fill the dirty water available there and kept horizontally in the sun on a black surface for as long as five hours. This makes the water not only potable but better than many tap waters available in the third world countries! This process is called SODIS.
* Malnutrition affects nearly 20% children in the villages and slums. This plays a major role in illness making the person more susceptible to most diseases. Although great progress has been made in various areas famine and drought make life miserable for millions especially in Africa even now. This needs serious attempt by the world community to redress. Water supply is the key to this effort. For example, 1 000 tons of water are needed to grow one ton of wheat. Solutions include more efficient use of water, recycling and sustainable use of dams and irrigation systems.
* Valerie Curtis of the London School of Tropical Medicine had shown that simple washing hands with soap and water would bring down diarrhoeal deaths by 50%. This was shown in an elegant study in India, the UK, the Netherlands, and the West Indies. Although hygiene is a common value in the world, aesthetic and social values play a greater role than health related motivation. Pesticides in drinking water are another great menace even in the developing countries due to bad agricultural practices.

* In many places, even in the West, the tap water is not of a good quality and is not potable. However, drinking mineral water is no solution. Firstly, the minerals in the water are not absorbed properly and are a waste anyway and, secondly, the water becomes very expensive. Many of them, at least in the developing countries, are not controlled for their quality adequately before being let into the market.

Daily water need for a healthy person:

Although there is no unequivocal evidence, as in many other areas of modern science, it is believed that around two litres of water, eight large glasses, is adequate for most adults. Children need proportionately more water than adults per Kg. body weight. Some others advice 30 ml of water for Kg. body weight for twenty four hours for adults. Reductionist scientists will swear that there is no study to show that one need to drink water at all! I think that is a lop sided view. In hot and humid environment this may have to be increased. Heavy sports and exertion could demand more water intake to avoid dehydration. Too much water could also be dangerous. One rough measure of adequate water intake is the colour of the urine. Clear urine or, at most, very faintly coloured urine denotes adequate hydration. Thirst and dry mouth are very late signs of dehydration. Micturating every three hours is a good sign. Most water intake should be done before mid afternoon to avoid sleep disturbance at night. Tea, coffee and cola drinks are mild diuretics and as such are not replacements for drinking water. On the contrary, they might necessitate more water intake. Adequate water intake would help keep the body weight under control in addition to avoiding constipation.

“The world is a dangerous place to live-not because of the people who are evil but because of the people who don’t do anything about it.”
Albert Einstein.